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How to deal with a tough trio: arthritis, anxiety and depression

Chronic joint pain is compounded by depression and anxiety.

Chronic joint pain is compounded by depression and anxiety.

Given it is February, the month of valentines and roses, I suggest we look at how we can better understand and deal with the all-too-frequent health companions: arthritis, anxiety and depression. Let’s incorporate some much-needed self-love and self-care into our Valentine’s Day equation.

I got to thinking about this trio of ailments after reading an excellent article about their relationship in a John Hopkins Medicine “HealthAfter 50” newsletter. It said that the Centers for Disease Control and Prevention (CDC) estimates that 50 million Americans have one of several forms of arthritis, including rheumatoid arthritis, osteoarthritis, gout, lupus and fibromyalgia.

The article also said that taken together, these related conditions are the leading cause of disability in the United States.

So, when I read a more recent article with the title, “One-third of people with arthritis have anxiety and depression,” I really took notice. Indeed, many of our clients suffer from some form of arthritis, often in conjunction with other debilitating or chronic diseases. At Andelcare, we always want to learn more to serve our families better.

How does depression and anxiety affect arthritis sufferers?

Physicians often use a multi-pronged approach to chronic pain.

Physicians often use a multi-pronged approach to chronic pain.

According to a CDC studyArthritis Care and Research,” this triumvirate greatly affects the emotional well-being of adults ages 45 and over. It takes a heavy toll:

  • Increasing levels of depression and anxiety led to decreasing levels of physical function and independence.
  • People who were depressed had little confidence in their ability to manage their arthritis or joint symptoms.

Of the survey respondents 31 percent were found to have anxiety and 18 percent had depression. There was significant overlap between the two conditions: 84 percent of those with depression also had anxiety, and 50 percent of those with anxiety also had depression.

But the shocker is that only half of the people with these mental health issues sought treatment for them over the past year. And although the correlation between depression and arthritis, especially rheumatoid arthritis, is well known, this study suggests anxiety may be even more common than previously believed and greatly under diagnosed.

Why is it so under diagnosed?

Michael Clark, MD, director of the chronic pain treatment program in the department of psychology and behavioral sciences at Johns Hopkins University says that mental health issues are likely underreported by patients. No one wants to be labeled as “crazy,” he says. Or they may not make a connection between their pain and depression.

But not diagnosing or treating one can impact the other greatly.

Joint pain often affects quality of life.

Joint pain often affects quality of life.

“People with mental health conditions definitely tend to have more functional limitations,” said Louise Murphy, PhD, lead author of the study and director of the Arthritis Program in the Division of Population Health at the CDC. “Having depression may mean someone doesn’t have energy to exercise, and someone with anxiety may not work out because they are afraid to fall and make their pain worse.”

That isn’t all. According to the National Alliance on Mental Illness, or NAMI, someone who has depression and a chronic illness may be less likely to adhere to his treatment, and more likely to smoke, drink alcohol, eat poorly and neglect physical activity. All of these behaviors can all lead to poorer outcomes.

How to improve outcomes

Because of the close relationship between treatment of mental health issues and improvements in pain and function, the study authors write, “Treating mental health conditions should be regarded as a fundamental part of managing arthritis symptoms.”

Antidepressants and anti-anxiety medications may help, but they aren’t the only treatment options, they write. Murphy recommends self-management classes for anxiety and depression, pointing out that a separate CDC study recently found that these classes were “associated with a considerable and sustained decrease in mental distress.”

6 Ways to Relieve RA Anxiety

So, what can we do to relieve depression and anxiety in ourselves or our loved ones who have arthritis and other related chronic illnesses?

In an article called “Six Ways to Relieve RA Anxiety” the author makes these suggestions:

Anxiety and RA Relief: Get a Massage

Therapeutic massage can relieve rheumatoid arthritis pain and relieve anxiety. Moderate massage can reduce pain, increase strength, and improve range of motion. A massage therapist will work the muscles and joints of your body, helping them become more loose, limber, and flexible.

Anxiety and RA Relief: Exercise

“Use it or lose it” may be an annoying catch phrase but it’s true, especially when you’re managing rheumatoid arthritis. Aerobic exercise and strength training both are helpful in relieving pain and reducing anxiety in RA patients, whether done in a traditional setting or in a water-based program.

Anxiety and RA Relief: Meditate

Meditation and relaxation techniques are a wonderful way to combat anxiety when you have rheumatoid arthritis. Studies show they can provide a buffer against anxiety and stress, improving your positive outlook on life.

Anxiety and RA Relief: Try Acupuncture

Acupuncture may help relieve arthritis pain.

Acupuncture may help relieve arthritis pain.

Acupuncture has been shown to relieve pain in people with rheumatoid arthritis. It can help reduce swelling, which decreases pain and increases energy which can lead to feeling less stress and more peacefulness.

Anxiety and RA Relief: Get Better Sleep

Rest is essential for handling anxiety from RA and other forms of chronic pain. A lack of sleep has been shown to prompt inflammation and make people more aware of their pain. On the other hand, people with rheumatoid arthritis who get adequate sleep feel less pain and feel happier and more positive.

Anxiety and RA Relief: Try a Hot Bath

A good soak in a hot bath can relieve rheumatoid arthritis pain. The hot water increases blood flow, relax tense muscles, and loosen tight joints. Just slip in, lay back and relax, and your anxiety will flow away with your RA aches and pains.

What do you do to reduce depression and anxiety?